TB outbreak in Nain soars to 50 cases

50 people being treated with either suspected, confirmed, or latent cases

CBC News · Posted: Jun 13, 2018 11:18 AM NT | Last Updated: June 13

Fifty people in Nain are now being treated for tuberculosis, up
from six suspected cases in April — although health officials say the
spread of the disease is showing signs of slowing.

There are 23
people with either confirmed or suspected active cases, as well as 27
people with latent TB, meaning they don't have any symptoms but still
require medication.

"The number we've been picking up has been
slowing down over recent weeks," said Dr. Gabe Woollam, the
vice-president of medical services with Labrador-Grenfell Health.

"I think
when we're dealing with an outbreak like this, we always expect to find
more cases around after the initial case. And I think it's an
indication that our contact tracing and our screening that we've been
doing is effective."

Labrador-Grenfell
Health increased its efforts to screen and treat tuberculosis in the
community following the death of 14-year-old Gussie Bennett, suspected
to have died from the disease.

254 people have been x-rayed so far in Nain, with another clinic planned next week. (CBC)

X-Rays, clinics ongoing

An
x-ray machine has been stationed in the community, on loan from the
federal government's National Emergency Strategic Stockpile, a
service that provides medical resources to communities in the midst of
crisis.

So far, 254 people have been x-rayed, with another clinic scheduled for next week.

"This
really makes life better for people, in that they can get all or most
of the investigations that they need for TB done in the community," said
Woollam.

"It's been critical actually, in terms of decreasing the
amount of people who've had to come to Goose Bay for follow up," added
Sylvia Doody, the director of health services with the Nunatsiavut
Government.

Doody said there have been numerous
clinics in Nain, with physicians either flying out to the community or
communicating via video or Telehealth. Two community meetings in 2018
have also involved in-depth conversations about tuberculosis treatment
and prevention.

Nain also dealt with a tuberculosis outbreak in 2014-15, where 14 people were diagnosed and one person died. (CBC)

"Challenges with compliance"

2018's
outbreak comes on the heels of one in 2014-2015, in which 14 people
were diagnosed and one man succumbed to the disease. Woollam and
Doody agreed it's been tough to keep tuberculosis on people's minds once
the initial crisis fades.

"When
there's an outbreak, people are very engaged with TB as a problem, and
are very anxious to get seen, treated and screened. But we do have
problems as we get further away from an initial outbreak," said Woollam.

"People
have other interests, and other things take over, and we have a harder
time getting people to clinics, follow up with medications, that type of
thing."

Up until now, people with latent tuberculosis usually
need a nine-month course of treatment, with medication either daily or
twice weekly. Woollam has hopes for a new drug regime that has just been
approved for Canada, which shortens that treatment time to a
once-a-week dose for 12 weeks.

Doody said there were
"challenges with compliance," and making sure people continue their
courses of treatment even after their symptoms fade. She said health
workers are trying different things, such as offering ice cream to kids,
doing home visits, or providing rides to clinics.

Fighting the stigma

As
the number of new cases slows, Doody said the community also needs to
take steps, encouraging each other "to support people — whether it's
family, friends, someone they know in the community — to help them
through that journey and take that long course of medication."

Our message is to try and educate the public on how difficult it is to catch TB.- Dr. Gabe Woollam

Both
Doody and Woollam said there's a need for more education about the
transmission of tuberculosis to fight the stigma surrounding the
disease.

Tuberculosis spreads through the air from person to
person, but is not spread by contact such as shaking hands, sharing
drinks or toothbrushes, and kissing.

"Our message is try to
educate the public on how difficult it is to catch TB in a casual
setting. In order to catch TB you need to be in close proximity to
somebody with TB for a prolonged amount of time, in a place that doesn't
have good ventilation, in close quarters," said Woollam.

"We want that message to get out so people aren't afraid to go to Nain or other communities where there is TB."

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